THE MEDICARE PAYMENT ADVISORY COMMISSION (MedPAC) – an independent body comprised mainly of physicians – has determined that doctors should be paid a 1.1 percent increase for Medicare services in 2009. This recommendation will appear in its annual March 1 advisory report to Congress.
At the January MedPAC meeting, John Richardson, a principal policy analyst for MedPAC, framed the meager increase against the fact that by law the Medicare fee schedule is projected to be negative every year through at least 2016.
MedPAC Chairman Glenn Hackbarth assured the recommendation was well-founded. The process of developing recommendations on updates is a difficult and often frustrating process for commissioners, he said. MedPAC conducts a rigorous study and its conclusions can be considered reasonable.
Access to care seems to be one of the hot buttons when Medicare payments are debated, and MedPAC conducts its own surveys to determine access to care. MedPAC's 2007 survey of Medicare beneficiaries found access was good, according to Richardson.
This is probably one of the easiest places to find major differences between MedPAC's view and that of some members of Congress. Though MedPAC's recommendation for an increase is on the conservative side, many key lawmakers see payment cuts and small, insufficient increases as threatening seniors and doctors alike.
Senate Finance Chairman Max Baucus (D-Mont.), concerned over access to care, said the committee plans to move aggressively to get some Medicare reform laws passed early this year.
Baucus and Ranking Senator Charles Grassley (R-Iowa) were bi-partisan co-sponsors of the Medicare, Medicaid and SCHIP Extension Act of 2007, passed in December, that gave doctors temporary relief of Medicare payment cuts through June 30.
If the Senate Finance Committee doesn't make good on its promise, doctors may have a difficult battle keeping this issue on the radar, with the increasing distractions of the presidential primaries and the War in Iraq.
Karen R. Borman, MD, MedPAC commissioner and a professor of surgery at the University of Mississippi, brought home reality to her colleagues at the January meeting when she said: "This whole discussion creates such a climate of at best angst, and perhaps at the other end outright hostility, that it's very difficult for the provider community to move past this conversation to taking a bigger picture view of our system and what can be done to make a better system."